不同运输方式下某部赴高原驻训人员急性高原反应发生情况调查

Survey on acute mountain sickness when army enters high altitude plateau by different transportation modes

目的研究不同运输方式下赴高原驻训人员的急性高原反应差异。方法随机抽签选取急进高原的300名男性官兵作为研究对象,根据运输方式不同分为3组,A组:从出发地(200 m海拔)乘飞机到达拉萨(3 680 m海拔),休整后公路运输到目的地(4 400 m海拔);B组:从出发地乘火车沿青藏铁路至拉萨站,休整后公路运输到目的地;C组:从出发地乘火车沿青藏铁路至格尔木站(2 800 m海拔),休整后公路运输到目的地。在出发地和目的地分别检测脉搏、血压和指血氧饱和度,采用急性高原反应国际标准进行问卷调查,分析3组高原反应发生率,并统计学分析各组差异。结果 3组调查对象的急性高原反应均为轻度,A、B、C组第1、2天高原反应发生率分别为39.1%、40.2%,33.0%、36.0%,46.0%、45.0%,组间差异有统计学意义(P<0.01),其中B组发生率最低。在海拔4 400 m阶段,3组调查对象的脉搏均在正常值区间,收缩压差异无统计学意义(P>0.05),而B组的血氧饱和度最高,达到(88.0±4.8)%,与A组(80.6±6.6)%、C组(84.7±4.0)%比较,差异有统计学意义(P<0.01)。结论充分利用铁路运输结合必要的公路运输,具有人员相对容易习服、适应环境快等优势,更适宜大规模人员向高原输送。

Objective To study the differences of acute mountain sickness of the army entering the high altitude plateau for field training by 3 transportation modes, and provide reference for the best transportation mode of entering the plateau to deal with emergencies in the future. Methods A total of 300 male army officers and soldiers were selected as the research subjects and divided into 3 groups according to the different transportation modes. Group A was transported by air from the departure place （200 m above sea level） to Lhasa station （3 680 m above sea level） and then to the destination by road transportation after a rest, group B was transported by train from the departure place to Lhasa station along the Qinghai-Tibet railway and then to the destination by road transportation after a rest, and group C was transported by train from the departure place to Golmud station （2 800 m above sea level） along the Qinghai-Tibet railway and then to the destination by road transportation after a rest. Questionnaire survey using the international standard of acute altitude sickness was conducted to analyze the response of the 3 groups at different altitudes. Other examinations included pulse, systolic pressure and finger blood oxygen saturation tests. The incidences of acute mountain sickness in the 3 groups was statistically analyzed. Results The incidences of acute mountain sickness in the 3 groups were statistically different （P 〈 0. 01 ）, and the incidence was lowest in group B. All cases were mild, and no moderate or severe altitude sickness was found. At the altitude of 4 400 m, the pulse of the 3 groups maintained in the normal range, and the systolic pressure among the 3 groups had no statistically significant difference （ P 〉 0. 05 ）, but the finger blood oxygen saturation of group B was the highest, reaching （88.0 ± 4.8） %, with statistically significant difference with group A [ （ 80.6 ± 6.6） % ] and group C [ （ 84. 7 ± 4. 0 ） %, P 〈 0. 01 ]. Conclusion The best mode for large-scale human transportation to the high altitude plateau is the combination of railway and road, which has the advantages of easier acclimation and quicker adaptation to the high-altitude environment.